Jesse Brown ED Orientation

1
Jesse Brown ED Orientation

• Chad Kessler, MD
• Henry Pitzele, MD
• Sarah Unterman, MD

2
IDs

• Must get an updated VA badge
• Activate it so you can swipe into the ED
• Via ED police (glass window station)

3
Notes

• Document every encounter, every patient
• Forward (identify additional signer) every note
  to the attending you present toor moonlighter at
  night/weekends
• Enter request for admission note for every
  admission and hand to clerk or walk to admitting

4
Seeing Patients

• Briefly see pt and/or hear about pt and review
  chart
• Place preliminary orders and tell RN to draw
  rainbow of tubes
• Have blood running while you do complete H and P
  and review chart
• Will expedite patient visit
• Please focus on an ED pace

5
Encounter Forms

• Please fill out encounter form on every patient
  you see
• Must correlate with correct visit and time
• Choose appropriate ED visit
• Emergency room (8AM to 4 PM)
• Emergency room evening (4 PM to midnight)
• Emergency room midnight (midnight to 8 AM)

6
Orders

• Use ED order sets
• Chest pain order set, etc
• On orders page
• Print all orders and labels Hand them directly
  to the RN
• Printer is A106 for orders
• Labels are preset printer
• Please inform the RNs of all orders
• Medications, labs, xrays, etc

7
Protocols

• Community Acquired Pneumonia
• Blood cultures and Abx within 4 hrs
• Protocol in ED for which abx
• Call pharmacy to acquire abx quickly
• ACS
• EKG in 10 minutes
• Troponin in 60 min (point of care testing)
• Door to balloon in 90 minutes
• Point of contact is attending cardiologist
• Community acquired MRSA skin and soft tissue
  infections
• Bactrim or clindamycin

8
Xray

• Order all xrays as outpt from 8AM to 4PM
• Inpatient xrays for all other times and for all
  CTs
• Call CT or xray to ask if they are ready for the
  patient

9
Laboratory

• Completed orders complete
• Active orders lab has them and are running
• Pending lab does not have them yet or is not
  running them yet CALL THEM!!!

10
Follow up

• Place consult for all follow ups
• Tell clerk if daytime and he/she may be able to
  make an appointment
• If clinic is full, talk with service and use
  their name for overbook
• For exampleDr. X from ENToverbook pt Y for
  Friday clinic

11
Paging

• Daytime
• ED book with surgical, medical, all consult pager
  numbers
• Call contacts with clerk as well
• Nighttime
• Oncall (see next page)

12
Resources

• Phonebook
• Type phonebook into any browser on the internet
  and you can get any names, pagers, dept. numbers,
  etc
• Oncall
• Type oncall into any browser and see list of call
  people for all services for day and night

13
Consultants

• Ortho
• Depending on week
• Either NWU or UIC
• General Surgery
• Last number of ss is odd NWU
• Last number of ss is even UIC
• For example last four of soc2323
• Would be a Northwestern Univ patient
• Need to call NWU surgery

14
Combinations for Rooms

• Call Room 312
• Supply Room 3524
• Med room 315
• Dirty Utility 312
• Keys for break room with RNs or Kessler

15
Enjoy

• Ask any questions you might have
• Enjoy the VA patient population
• And most of all, please have fun this month!!!!
• Chad Kessler
• Office 312 569-6508
• Pager 312 389-3696